The drug overdose epidemic is rapidly evolving in tennessee (TN)

Opioid prescribing for pain decreased by 32% in the last five years (2017-2021). TN's controlled substance monitoring database (CSMD) has been a critical tool in this fight. Despite lower prescribing, trends reflect a shift from an epidemic largely driven by prescription pain relievers to one that includes illicit opioids and stimulants. To continue the progress TN has made in tracking drug overdose and prescription misuse and abuse in our state, TDH plans to carry out four activities during the three year grant period: 1.) continue rxcheck interstate data sharing onboarding and pilot an additional facility for CSMD electronic health records (EHR) integration; 2.) provide support for the hosting and maintenance of the enhanced application for submission of controlled drug shipment data 3.) develop an in-depth education program for CSMD system users; and 4.) enhance public health and public safety partnership to build a framework for information sharing to address the drug overdose epidemic. The CSMD has been a key tool in TN's steady decline in opioid prescribing. The first grant activity includes expanding options for querying interstate data using rxcheck, and better integrating the CSMD into EHR utilizing rxcheck. These efforts will expand CSMD access and enhance provider workflows, so they are able to make better clinical decisions. The second activity will provide support to the hosting and maintenance of the drug shipment data application. The previous system was approaching end of life, and the new application will improve data used for surveillance and tracking of shipment outliers to prevent and investigate inappropriate drug orders. The third activity will develop an in-depth education program for system users. The CSMD educational program was in a state of dormancy, the plan is to revitalize the CSMD education program. A resource hub of training tutorials, presentations, and booklets will be developed and made available to all CSMD system users to provide instructional tutorial video trainings. The fourth activity will enhance a public health and public safety partnership to build a framework for information sharing. This partnership will build on the existing relationship TDH currently has with the tennessee bureau of investigation (TBI) as we expand and include additional public safety agencies. This additional information will be valuable as we create a data infrastructure that can rapidly identify changing trends in the drug overdose epidemic and provide data to key stakeholders.